Atch 3 to Sect L - Past Performance questionnaire.pdf

Attachment 3 to Section L

SOURCE SELECTION SENSITIVE

PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor: ______________________________________________________________________________

B. Cage Code of contractor contract was awarded to: _________________________________

C. Contract number: _______________________________________

D. Contract type: ______________________________

E. Was this a competitive contract? Yes _____ No _____

F. Period of performance: _________________________________________________________

G. Initial contract cost: $____________________________

H. Current/final contract cost: $_______________________________

I. Reasons for differences between initial contract cost and final contract costs: ___________________________

J. Description of service provided:_______________________________________________________________

SECTION 2. CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name: _________________________________________________________________

B. Customer or agency description (if applicable):

C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

SECTION 3. EVALUATOR IDENTIFICATION

A. Evaluator's name:

B. Evaluator's title:

C. Evaluator's phone/fax number:

D. Number of years evaluator worked on subject contract: _____________________

SOURCE SELECTION SENSITIVE

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE LEVEL

B BLUE/EXCEPTIONAL - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

P PURPLE/VERY GOOD- The contractor’s performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

G GREEN/SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Y YELLOW/MARGINAL – Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

R RED/UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N NOT APPLICABLE - Unable to provide a score.

B

P

G

Y

R

N

Performance Requirements

T1. Ability to accurately document the system requirements and requirements verification matrix into specifications

T2. Ability to successfully demonstrate the product baseline legacy capabilities prior to contract award

T3. Ability to produce/manufacture the product from low rate initial production (LRIP) to full rate production.

Systems Engineering and Management Processes

P1. Effectiveness in planning and executing Systems Engineering to successfully design, develop, manufacture, test and deliver products and services

P2. Effectiveness and efficiency of the overall acquisition management approach

P3. Quality/integrity of the Configuration Management Process

P4. Quality/integrity of Quality Control/Assurance process

P5. Quality of testing including DT&E and OT&E support

P6. Quality/effectiveness of sub-contracted efforts

P7. Effectiveness of material management (including Government Furnished Property or Material)

P8. Ability to meet program milestones

B

P

G

Y

R

N

Product Support/Training

L1. Ability to implement the Unique Identification (UID) policy

L2. Quality of Contractor Logistics Support (CLS)

SOURCE SELECTION SENSITIVE

L3. Quality of users manuals for operation and field repair

L4. Quality of training support

Cost Performance

C1. Accuracy in forecasting contract costs

C2. Ability to meet forecasted costs and perform within contract costs

C3. Ability to alert Government of unforeseen costs before they occur

C4. Sufficiency and timeliness of cost reporting

2. Please discuss each and every response for which you indicated B/E (Blue/Exceptional), Y/M (Yellow/Marginal) or R/U (Red/Unsatisfactory) in response to the questions above (use additional sheets, if necessary).

3. Government Contracts Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

Yes___ Default___ Convenience___ Pending Terminations___ No ___

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5: NARRATIVE SUMMARY

What were the contractor’s most positive aspects in the performance of the contract?

What were the contractor’s most negative aspect in the performance of the contract?

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

Please provide any additional comments concerning this contractor’s performance, as desired.

SOURCE SELECTION SENSITIVE

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address:

Or FAX to: